The research team found patients and health care professionals sometimes think differently about what is important. And that it’s important to base treatment decisions on what patients think.
This study was open for people to join between 2013 and 2014, and the research team published the results in 2017.
About this study
The research team talked to 49 patients and 73 health care professionals, to see what they thought about the different treatment options for laryngeal cancer.
First, they explained the treatment options using videos, recordings and pictures.
Then they gave people 4 outcomes to rate from the best option to worst option. They were:
- chemoradiation that had gone well
- chemoradiation with some side effects
- surgery that had gone well
- surgery with some side effects
They then did an exercise for each of these options. They asked people to choose if they would prefer to live for a number of years with side effects from treatment, or to live for less time but with normal health.
The research team worked out a score called a utility value for each treatment option. This helps them assess how important quality of life is to people. There is more about this in the ‘results’ section below.
The research team asked the people taking part which treatment they thought they’d prefer to have. It was similar for patients and health care professionals:
- 2 out of 3 people said chemoradiation
- 1 out of 3 people said surgery
Working out the utility value
Researchers looked at how much value people put on being healthy and having a good quality of life. This is called the utility value. It’s a way of assessing whether people would be willing, in theory, to live for less time but have a better quality of life during that time.
The utility value is a number between 0 and 1.
If the score is nearer 0, it means people feel the side effects and impact of treatment would greatly affect their quality of life. So they would be more prepared to live for less time, but with a better quality life.
If the score is nearer 1, they don’t feel the side effects or impact of treatment would have that much effect on their quality of life. So they wouldn’t be as prepared to live for less time, because the increase in quality of life would only be small.
The results showed that for each treatment option, the scores were a bit lower for patients than for health care professionals (HCPs). This means that the side effects and reduced quality of life have a bigger impact on people’s decision making than HCPs realise.
Utility scores for the different treatment options
|Chemoradiation that went well
|Surgery that went well
|Surgery with more side effects
|Chemoradiation with more side effects
At the end of the process, the researchers asked people again which treatment they would prefer. They wanted to see if, after talking about it in more detail, anyone had changed their mind. They found that:
- 10 patients and 11 health care professionals changed from chemoradiation to surgery
- 8 patients but 0 health care professionals changed from surgery to chemoradiation
They asked people if they would change to the other treatment (the one they’d prefer not to have), if it meant they would live longer. Some people said they would not:
- 4 out of 73 health care professionals (5%)
- 15 out of 49 patients (31%)
Some people said they would change their mind to the other treatment. But only if it meant they would live, on average, an extra:
- 2.6 years (health care professionals)
- 2.8 years (patients)
The research team concluded the health care professionals and patients think about and value treatment options and side effects differently.
They recommend that decision making tools should include more information about what patients think is most important to them.
Where this information comes from
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed
) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.